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Addiction is defined as a chronic brain disorder. Were you fall back and continue abusing for example drugs, without thinking about the consequences.

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Why it is defined as a chronic brain disorder is because the brain circuits functions changes that has to do with reward, stress, and self control.

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A big problem is that even if you stop misuse drugs, the changes that has already been done in you brain lasts for a while. That makes it harder for one to stop misuse drugs.

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Why drugs are used is because of stress, social and academic pressure, and anxiety etc.

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"Stress can play a major role in starting and continuing drug use as well as relapse." In today's society stress is increasing because of social media and pressure from surroundings.

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What is drug addiction?

Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.

Addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.

Modified with permission from Volkow et al. 1993.

Note: These PET scans compare the brain of an individual with a history of cocaine use disorder (middle and right) to the brain of an individual without a history of cocaine use (left). The person who has had a cocaine use disorder has lower levels of the D2 dopamine receptor (depicted in red) in the striatum one month (middle) and four months (right) after stopping cocaine use compared to the non-user. The level of dopamine receptors in the brain of the cocaine user are higher at the 4-month mark (right), but have not returned to the levels observed in the non-user (left).

Why do people take drugs?

In general, people take drugs for a few reasons:

To feel good. Drugs can produce intense feelings of pleasure. This initial euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the high is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opioids such as heroin is followed by feelings of relaxation and satisfaction.

To feel better. Some people who suffer from social anxiety, stress, and depression start using drugs to try to feel less anxious. Stress can play a major role in starting and continuing drug use as well as relapse (return to drug use) in patients recovering from addiction.

To do better. Some people feel pressure to improve their focus in school or at work or their abilities in sports. This can play a role in trying or continuing to use drugs, such as prescription stimulants or cocaine.

Curiosity and social pressure. In this respect, teens are particularly at risk because peer pressure can be very strong. Adolescence is a developmental period during which the presence of risk factors, such as peers who use drugs, may lead to substance use.

If taking drugs makes people feel good or better, what's the problem?

When they first use a drug, people may perceive what seem to be positive effects. They also may believe they can control their use. But drugs can quickly take over a person's life. Over time, if drug use continues, other pleasurable activities become less pleasurable, and the person has to take the drug just to feel "normal." They have a hard time controlling their need to take drugs even though it causes many problems for themselves and their loved ones. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. These are the signs of an addiction.

Even relatively moderate drug use poses dangers. Consider how a social drinker can become intoxicated, get behind the wheel of a car, and quickly turn a pleasurable activity into a tragedy that affects many lives. Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including impaired driving and overdose.

Do people choose to keep using drugs?

The initial decision to take drugs is typically voluntary. But with continued use, a person's ability to exert self-control can become seriously impaired. This impairment in self-control is the hallmark of addiction.

Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control. These changes help explain the compulsive nature of addiction.

No single factor determines whether a person will become addicted to drugs.

Why do some people become addicted to drugs, while others do not?

As with other diseases and disorders, the likelihood of developing an addiction differs from person to person, and no single factor determines whether a person will become addicted to drugs. In general, the more risk factors a person has, the greater the chance that taking drugs will lead to drug use and addiction. Protective factors, on the other hand, reduce a person's risk. Risk and protective factors may be either environmental or biological.

What biological factors increase risk of addiction?

Biological factors that can affect a person's risk of addiction include their genes, stage of development, and even gender or ethnicity. Scientists estimate that genes, including the effects environmental factors have on a person's gene expression, called epigenetics, account for between 40 and 60 percent of a person's risk of addiction. Also, teens and people with mental disorders are at greater risk of drug use and addiction than others.

Children's earliest interactions within the family are crucial to their healthy development and risk for drug use.

What environmental factors increase the risk of addiction?

Environmental factors are those related to the family, school, and neighborhood. Factors that can increase a person's risk include the following:

Home and Family. The home environment, especially during childhood, is a very important factor. Parents or older family members who use drugs or misuse alcohol, or who break the law, can increase children's risk of future drug problems.

Peer and School. Friends and other peers can have an increasingly strong influence during the teen years. Teens who use drugs can sway even those without risk factors to try drugs for the first time. Struggling in school or having poor social skills can put a child at further risk for using or becoming addicted to drugs.

What other factors increase the risk of addiction?

Early use. Although taking drugs at any age can lead to addiction, research shows that the earlier people begin to use drugs, the more likely they are to develop serious problems. This may be due to the harmful effect that drugs can have on the developing brain. It also may result from a mix of early social and biological risk factors, including lack of a stable home or family, exposure to physical or sexual abuse, genes, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.

How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this powerful contrast drives some people to repeatedly use drugs to recapture the fleeting pleasurable state.

Images of Brain Development in Healthy Children and Teens (Ages 5-20)

As the brain matures, experiences prune excess neural connections while strengthening those that are used more often. Many scientists think that this process contributes to the steady reduction in gray matter volume seen during adolescence (depicted as the yellow to blue transition in the figure). As environmental forces help determine which connections will wither and which will thrive, the brain circuits that emerge become more efficient. However, this is a process that can cut both ways because not all patterns of behavior are desirable or healthy. The environment is like an artist who creates a sculpture by chipping away excess marble; and just like bad artists can produce bad art, environments with negative factors (like drugs, malnutrition, bullying, or sleep deprivation) can lead to efficient but potentially harmful circuits that conspire against a person's well-being.

The brain continues to develop into adulthood and undergoes dramatic changes during adolescence.

One of the brain areas still maturing during adolescence is the prefrontal cortex-the part of the brain that allows people to assess situations, make sound decisions, and keep emotions and desires under control. The fact that this critical part of a teen's brain is still a work in progress puts them at increased risk for trying drugs or continuing to take them. Introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences.

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Drug Misuse and Addiction | National Institute on Drug Abuse

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What is drug addiction? Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.† It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control.

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If drugs have so many good effects and feels so good. Why should you stop? Well, the problem is that after a while you can't stop taking the drug. Because you do no longer feel "normal" if you stop taking the drug daily. This can eventually and easily develop into a addiction.

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"Occasional drug use, such as misusing an opioid to get high, can have similarly disastrous effects, including overdose, and dangerously impaired driving."

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Everyday drugs such as opioid drugs can be more dangerous than most people think. They can have the same effect as a stronger drug but the effect is just not as strong. Today there is a lot of students among others overdosing on opioid drugs because it is easy for them to get the hold on the prescriptive drugs.

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Why do people continue using drugs if they are dangerous? There is a study done were you could see that the brain of someone that had an addiction had physical changes in the critical judgment area of the brain. The area also covered decision making, learning and memory, and control of behavior.

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How people get addicted to drugs and opioid drugs is a difficult question. The reason a person can develop an addiction can be biological and/or environmental.

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The misuse of prescription opioids, CNS depressants, and stimulants is a big problem in America. Even though there is a lot of people who take opioids responsibly there is still a percentage of people who misuse them

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"In 2017, an estimated 18 million people (more than 6 percent of those aged 12 and older) have misused such medications at least once in the past year"

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According to the National Survey on drug use and health, during the year of 2017 more than 2 million people misused prescriptive pain relievers for the first time.

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This shows that the misuse of prescriptive medicine is continuing. Why that is, can be because of many different reasons such as age and gender. Although one big reason is the easy accessibility. The amount of opioids prescript-ed has increased rapidly since 1990.

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Many people also think that prescript-ed drugs and medicines are less harmful than illegal drugs. Thus, they don't know about the harmful consequences of these prescript-ed medicines if misused.

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"Misuse of prescription drugs is highest among young adults ages 18 to 25, with 14.4 percent reporting non-medical use in the past year."

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Ordering Publications

Call 1-877-643-2644 or:

APA Style MLA Style AMA Style

NIDA. (2018, December 13). Misuse of Prescription Drugs. Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs

​Research Reports

This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.

Lesson Plan and Activity Finder

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What is the scope of prescription drug misuse?

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Call 1-877-643-2644 or: APA Style MLA Style AMA Style NIDA. (2018, December 13). Misuse of Prescription Drugs. Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.

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The misuse of prescriptive drugs is very common among 12th graders in high school, after alcohol, tobacco and marijuana. Adderall is one popular drug that students misuse, it's a stimulant that helps with difficulty in concentration.

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Even though the misuse of these prescription drugs increased, and the percentage was very high between 2002-2013. The percentage and therefor misuse of the medications has now decreased again during 2017.

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Students who misuse prescriptive medication are more likely to use other drugs as well. Such as alcohol, marijuana and heavy smoking. Students who get prescriptive medication in a early age also run a bigger risk of misuse and get addicted to the opioids drugs later in their life.

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Even older adults misuse prescript-ed drugs. At least 80 % of people in ages 57-85 use prescript-ed drugs on a daily basis. Different chronic illnesses and different use of medications can also be very dangerous. Therefor the use of the opioid drugs can be more dangerous for some older people if you compare to the younger generation.

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"In more than 40 states, pharma-related bills are pending or recently passed."

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The high cost of prescription drugs is on everyone's agenda. In more than 40 states, pharma-related bills are pending or recently passed. President Trump, Health and Human Services Secretary Alex Azar, Food and Drug Administration Commissioner Scott Gottlieb and the Centers for Medicare and Medicaid Services have advanced proposals to bring down prices. Congress passed an anti-gag clause bill, letting pharmacists give more information to patients to help them save on costs.

It is no surprise that public officials, hearing the drumbeat of complaints from the public, are scrambling to get a handle on the problem. Drug prices have risen at an alarming rate in recent years, outpacing all other aspects of health-care spending, including nursing home costs.

Specialty drugs lead the way with eye-popping price tags - current therapies for hemophilia are priced at $580,000 to $800,000 a year; Novartis plans a $475,000 price tag for its Car-T drug Kymriah, which treats non-Hodgkin's lymphoma.

But it is not just prices for new drugs and rare conditions that are causing so much pain. Pharmaceutical companies have raised prices most sharply for commonly used medications to treat diabetes, high cholesterol and asthma.

How did we get here? The answer can be found in this country's shadowy and byzantine system for negotiating drug prices and rebate deals. The system contains odd and perverse incentives, with the result that higher- priced drugs can receive more favorable health-plan coverage, channeling patients toward more expensive drugs.

At the heart of the system lies the industry known as pharmacy benefit managers (PBMs). Historically, PBMs operated mostly as claims processors. Although the industry experienced significant shifts in the 1990s when claims processing moved to the digital world, the real transformation took place in 2006. In that year, prescription drug coverage became part of Medicare, introducing a massive influx of patients with prescription drug coverage into the market. PBMs took on an additional role for a wide range of health plans: helping plans set formularies (the terms on which patients can access drugs) and negotiating prices with drug companies. The rise in prices that followed has been dramatic. Between 2006 and 2014, prices for drugs rose by an average of 57 percent, and prices for drugs with no generic substitutes rose by 142 percent.

What caused the increases?

Here is how our current system works. It starts with a structure that looks healthy on the surface. Health plans pay their PBMs based on the extent of the discount that a PBM can negotiate with individual drug companies. In theory, this should encourage the PBM to drive prices down. After all, entities should bargain hard when their pay is tied to how much of a discount they can negotiate.

The problem? Drug companies raised their prices so they could give a greater discount. This increases how much of a "discount" the PBM can claim to have negotiated, and the payout to the PBM. It is a little like a department store raising prices right before a sale so the sale discount looks more appealing.

All of this might not be so bad if no one paid the high list price. But many people do. Many plans make patients pay full drug costs until they meet their deductible, and other plans require coinsurance - both of which are based on the list price. Many people still do not have coverage for prescription drugs, even if they have health insurance. Thus, people are forced to pay the full price at various times. Worse yet, the entire structure encourages drug companies to compete not by cutting prices but by offering higher prices.

Pharmaceutical companies offer the same types of rebate deals to hospitals, to clinics that administer medication and to doctors who deliver medication such as injections or infusions in their offices. The hospital or other facility charges the patient a higher list price and then receives a rebate later from the drug company, ultimately pocketing the difference. And they also provide other types of payments under labels like "administrative fees" and "data fees." If policymakers try to reduce or eliminate rebates, drug companies can still provide payments to everyone in the distribution chain by shifting that flow of money to other types of fees.

The name of the game is volume. The more volume a drug company has with a particular PBM or hospital, the better deal it can offer as a temptation to exclude rival drugs. It is a little like Budweiser going to a bar owner with the following offer: "Okay, at the end of the year, I'll pay you 50 cents a bottle if you've sold 40,000 bottles of Bud. Better yet, I'll make it $1 a bottle if you don't put any of that microbrewery's beer on the menu." If the microbrewery starts out by selling a limited number of bottles, how could it ever compete? The little guy could never offer enough off the price on its few beers to compensate for the tens of thousands of dollars the bar owner would forgo by rejecting Budweiser's offer.

These rebate spreads and other fees are clearly incentives to prescribe the drug. In exchange for lucrative payments, a drug company can ensure that more expensive drugs receive a more favorable reimbursement position and less expensive drugs are shut out. This narrows prescription choices and undermines competition from generic drugs and from other drugs within the same class of medications that might provide excellent results at a lower price.

In 2013, when the Supreme Court handed down a decision that cast doubt on the drug companies' practice of paying generic competitors to stay off the market, drug companies doubled down on other strategies designed to hobble generics, including these rebate schemes.

Government also plays a role. Many of these drugs are protected by strong patents and other exclusivity rights that give the company a monopoly over the market. Drug companies apply for these benefits in a variety of ways, including by performing pediatric testing, pursuing other new clinical studies, developing so-called orphan drugs and creating drugs for tropical diseases. Companies can manipulate this rights system to their advantage during negotiations with hospitals, doctors and health plans. For example, a government-protected monopoly can be used to arrange protection for other drugs that are facing competition.

Recent real-world examples of this cycle of market manipulation abound. For example, in October 2017, Shire sued Allergan alleging that Allergan used bundled rebates to preserve the dominant market share of its blockbuster dry-eye medication, Restasis. In addition to the company's monopoly position in the dry-eye medication market, the company controlled the market for glaucoma drugs, for which no generic drugs were available.

When the FDA approved a new drug in the dry-eye market, the company offered a plan in which attractive deals in the glaucoma market would be available for those who also gave favorable treatment to the company's dry-eye medication. According to one Medicare plan administrator quoted in the complaint, given Allergan's bundling scheme, a competitor could give the new drug away free and the numbers still wouldn't work.

What does all of this mean? Patents and exclusivities are intended to incentivize innovation in the drug industry, providing a time-limited monopoly to recoup costs followed by vigorous competition to bring the price down to competitive levels. Instead, drug companies are manipulating the system, often recycling and repurposing drugs rather than inventing new ones. In fact, 78 percent of the drugs associated with new patents were not new drugs coming on the market but existing ones. The cycle of innovation, reward, then competition is being distorted into a system of innovation, reward, then more reward.

At the end of the day, drug companies are able to use financial incentives to ensure that as lower-priced alternatives enter the market, they cannot gain much of a foothold. The companies have simply found a way to operate within the system to their own greatest advantage. Can one really expect anything different from profit-making enterprises?

Unfortunately, it is lose-lose for the rest of us. Manufacturers raise the price, and at least some patients pay the higher price. With those who don't, the money created by the rebate spreads to the middle players - PBMs, hospitals and doctors - who then extend competition-free zones for the drug company's drug. In the short term, society pays more in the form of higher prices; in the long term, society pays more in the form of fewer competitors to offer lower-priced drugs. Today and tomorrow, society pays and pays again.

The pharmaceutical industry has introduced extraordinary health-care advances. One cannot overemphasize the major life improvements over the past century that flow from innovation in prescription medications, including new lifesaving antibiotics, treatments for pain, psychopharmacological treatments and cancer drugs. As one physician pointed out to me, former president Jimmy Carter has already lived several years beyond his diagnosis of metastatic cancer, thanks to a drug that did not exist a decade ago. However, if we don't get a handle on the perverse incentives operating throughout the system, we may be pricing ourselves and our economy into oblivion.

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Perspective | Why prescription drug prices have skyrocketed

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The high cost of prescription drugs is on everyone's agenda. In more than 40 states, pharma-related bills are pending or recently passed. President Trump, Health and Human Services Secretary Alex Azar, Food and Drug Administration Commissioner Scott Gottlieb and the Centers for Medicare and Medicaid Services have advanced proposals to bring down prices.

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"Anti-gag clause bill", is a bill that allows pharmacy workers to inform the buyer more information about cheaper alternatives to the medication that they are buying.

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The expense of drugs have increased the past years and this is a big question in the political world. The prices for drugs are even higher than other medical health care costs.

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The prices for new drugs are much higher if you compare with the standard constant drugs

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Although the price for new drugs is high, pharmacy are also increasing the price for common used drugs such as drugs used for debates and asthma, to earn more money.

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"At the heart of the system lies the industry known as pharmacy benefit managers (PBMs)"

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The industry experienced big changes when the digital world advanced their way of working. In 2006 the prescription drug coverage became a part of medicare and this increased the amount of people using the prescription drug coverage.

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PBMs helped costumers with health plans and gave them a way to get easier access to drugs, and introduced cheaper alternatives.

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The problem behind the rising prices is that drug companies wants to rise their prices so that they can have greater discounts.

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Hospitals and other facilities charge higher prices for drugs. They later receives a rebate from the company or they are keeping to change.

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"Administrative fees" and "data fees" can also occur in the facilities, for them to earn more money. Even if policymakers try to eliminate rebates, the drug companies can still create other fees that have to be paid instead.

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Drug companies make deals with particular PBMs or hospitals which gives them benefits and gives them the opportunity to raise their prices. Also, many drugs are protected by strong patents and other exclusivity rights that gives the company monopoly over the market.
Many companies advertise the most expensive drugs as being the best despite the fact that some cheaper drugs can be just as good. They do this for the obvious reason, to increase their income.